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Peritumoral brain edema associated with pediatric brain tumors: characteristics of peritumoral edema in developing
A Kawamura1, T Nagashima, K Fujita
1Department of Neurosurgery, Kobe University School of Medicine, Japan.
Insights
Pediatric brain tumors generally show less peritumoral brain edema than adult tumors. However, some pediatric tumors causing hydrocephalus can exhibit significant brain edema.
Area of Science:
- Neuro-oncology
- Pediatric Radiology
Background:
- Peritumoral brain edema in pediatric brain tumors is not well understood.
- Clinical significance requires further investigation.
Purpose of the Study:
- To clarify the clinical significance of peritumoral brain edema in pediatric patients.
- To compare pediatric and adult brain tumor edema characteristics.
Main Methods:
- Studied 77 pediatric patients (<15 years) with brain tumors using MRI.
- Measured peritumoral edema and tumor volumes.
- Compared pediatric data with 408 adult brain tumor patients.
Main Results:
- Lower incidence and severity of peritumoral edema in pediatric supratentorial tumors compared to adults.
- 42% of pediatric supratentorial gliomas had edema vs. 63% in adults.
- Pediatric intraventricular/paraventricular tumors with hydrocephalus showed significant edema.
Conclusions:
- Pediatric brain tumors typically have less peritumoral edema than adult tumors.
- Developing brain biology and tumor histology contribute to lower edema incidence/severity.
- Obstructed hydrocephalus in pediatric tumors can lead to marked edema.
Abstract:
The incidence and clinical significance of peritumoral brain edema in pediatric patients is not well understood. The purpose of this study is to clarify the clinical significance of peritumoral brain edema in pediatric patients. Seventy seven pediatric patients (under 15 year old) with brain tumor were studied by MRI. The volume of peritumoral edema and brain tumor were measured by integration of the cross-sectional area on serial MRI. The severity of brain edema was expressed by the ratio of edema volume to tumor volume. The results were compared with that of 408 adult patients with brain tumor. Incidence of the brain edema associated with supratentorial tumors is lower in pediatric group than in adult. Severity of brain edema is also less extent in the pediatric group. Forty two percent of supratentorial gliomas in pediatric group showed peritumoral edema. On the other hand, 63% of adult group showed peritumoral brain edema. In general, pediatric brain tumors rarely associated with marked peritumoral brain edema which observed in the adult group. However, intraventricular or paraventricular tumors with obstructed hydrocephalus showed remarkable brain edema in pediatric group. Low incidence and less severity of peritumoral edema are caused not only by histological bias of tumors, but also by the biological nature of developing brain.